Too Low for Good

Over the w-e, Holly and I did a run/walk on our usual route that goes up and over the hill behind our house in Asheville. I knew that my red blood cells were low from the lab check on Friday. I was so slow and poky on those hills and had to walk up instead of running. It frustrates me even though my friend Karen Nelson tells me to chill about it since I've had chemo, chemo and well, more chemo. It makes me laugh to read her take on it and realize how silly I am about trying to maintain my previous level of fitness through chemo and low cell counts of all kinds. We did a hike on Sunday that I knew was going to be moderate to strenuous and warned my pals that my counts were too low for me to be good at going up. I was quite self-conscious about holding anyone back. But we all did great, enjoying the wildflowers and the trees and the creek, albeit at a slower pace than usual.

All that being said, I did have a mighty nice run this morning after getting tanked up with blood yesterday. Feels good to be zippy again. It has really given me an appreciation for all my patients have to put up with if they are anemic or have a low heart output. I'm reading a really good textbook right now on the Essentials of Geriatric Medicine, and they talk alot about how to assess if the elderly have the energy and stamina to do their ADL's (activities of daily living, e.g. dressing, cooking, bathing). I think I have a lot better appreciation for how it feels to dwindle. I get to dwindle with each cycle of chemo. At least I get to look forward to rebounding each time too. Nice.

Holly and the kitties were interested in the TV news last night. I'm still working on the Sunday NY Times, my favorite.

Not on My Time

Last week from Wednesday on, I kept waiting for my white cell count to rebound and start coming back up. A rebounding white cell count shows that the bone marrow is recovering again after all that strong chemo. I kept waiting and waiting. Oddly, on Friday, my platelet count was holding steady, but the white count and red blood cell count were lower than the time before. It was like my bone marrow was trying to turn around but just couldn't do it. Since my hemoglobin was low, I felt more tired and short of breath on my runs and walks uphill. I talked to my friend Susan about it over the w-e, and we were commenting on how it is not on my time. It recovers when it recovers. It is that patience thing again, and again, and again. It is obvious that my bone marrow doesn't recover as quickly when the rounds of chemo stack up. I guess that is not really surprising. More hits to the marrow.

But here's the good news. Today my white cell count is up to 0.9 from 0.3 on Friday. And the platelets are up to 67,000 from 21,000. The bone marrow is doing its thing. Yeah! I am going to get transfused 1 unit of red blood cells since the hemoglobin is 8.7. When it is below 10.0, I feel draggy and more tired. I can really notice it when I run hills; I get more short of breath and tired and have to stop to walk some. Later today, I'll be all tuned up after this blood and with my bone marrow doing its thing at last.

I saw my doctor briefly this morning. He agreed to see me in clinic Monday and will admit me to the hospital Tuesday to start the next round of chemo, another 5 day affair like before. I have been studying the calendar pretty closely because I don't want to get backed up on these chemo rounds and end up having my November chemo during Thanksgiving. I want to move, move, move on the next round (see I still haven't learned the patience thing...)

Birdhouses

A few people asked me where I took the picture of the birdhouses. They are on my walking loop through downtown Hillsborough. One of the historic houses has a small driveway on the side of their house. They have lots of nice roses in beds in their yard and the collection of cool birdhouses at the end of their driveway. I just smile everytime I see them. I have this walking loop that I like to do down to a small street called Margaret Lane that runs along the Eno River. The loop from our house to Margaret Lane passes by many beautiful historic homes with leafy trees and interesting yard art. The first part of the walk is a net downhill and obviously the second part is uphill. I like that, because well, I like hills alot. Sometimes we do the loop after dinner too because Locopops, the place that sells homemade palletas or popsicles, is on Margaret Lane. Right now, the Hillsborough public library is about halfway between our house and Margaret Lane, but they are building a big new library on Margaret Lane right next to Locopops. I do really enjoy the walks around town - watching the flowers come and go, the leaves change, and the others walk their loops.

I'm sitting in the clinic waiting for my labs to come back for the day. If things are turning around, then my counts will be coming up. My bone marrow will be manufacturing all of those necessary components that fill me with vim and vigor. I hope that I've already reached the nadir from this last round of chemo and that everything is on its way back up. If we get a break from the clinic, we'll go to Asheville at some point this w-e.

This is a cool piece of yardart that doesn't come out well in the photo. Hopefully you can see metal flower at the end of the tall pole. It turns in the wind producing a changing pattern of flower with time.

Just got my labs, the white cell count is just a smidge lower than last time at 0.3 but the platelets are holding at 21,000 and hemoglobin at 9.0. They have to decide whether to have me come back Sunday or Monday. Arggh! I can to keep (re)learning that I am not in control. We were commenting on the drive in about how this leukemia teaches you patience.

Blustery Day

I guess it's going to really show us that it is fall. We are supposed to get windy conditions all day with rain from a Noreaster on the coast. The grass will quit growing soon, and all those mower sounds will go away until next year.

I've done my workout for the day and now I'm sitting in our living room near the big windows. I'm sipping earl grey tea since I haven't been able to get back to coffee yet since my last chemo round. My stomach can't handle the acid, I think. I get this weird taste in my mouth from the chemo that doesn't mix well with the taste of coffee. Actually the taste is yucky with or without coffee, but it does go away after 7 to 10 days. And I promise you, it is nothing compared to the bad taste I had from the breast cancer chemo. That one stayed with me for a good 2 months or so after I completed the last treatment. So this one is mild in comparison really. Karen and Freddi sent me a care package in July, and I am still using the Lifesavers to mask the taste. It works.

Platelets Again

I am sitting in my usual spot in front of the big sunny window on side B of the clinic. The patient load seems light here today as many of the Duke blue recliners are empty, at least on this side of the clinic. We are all busy doing computer work or reading or studying something. I am waiting on a bag of platelets to arrive from the hospital since my platelet count is back down to 10,000. The other numbers are almost the same as 2 days ago; my hemoglobin is 9.7 and my white cell count is 0.4. This should be the nadir with my counts going up over the next few days. I was hoping they would be rebounding today so that Holly and I would know for sure that we'd be able to go to Asheville this w-e. It's nice to plan ahead when you can. Now we'll have to wait until Friday to see how the counts are doing and whether we'll get the w-e off from clinic to do some mtn traveling.

I received an email today from my clinic supervisor at Piedmont Health Services. She is pretty sure she will still have a place for me at that center when I return to work in January. Great news! I was worried that I might be re-assigned to a different center due to staffing changes.

It was a little chilly on my run this morning. Felt really good to wear a long sleeve shirt for a change.

No Clinic Today

It'll be a quiet day without clinic today. I've done my rowing workout, my pushups, and my stretches. While I was working out, Dad and Lynn took a walk through historic downtown Hillsborough all the way to Weaver St Market and back. They aren't used to the slightly hilly streets here so they got a good workout too.

Dad was busy cooking up a storm yesterday after clinic. He made a vanilla pound cake, banana pudding, and for dinner a baked halibut with tomatoes and onions, oven roasted acorn squash, and brussel sprouts. Very good dinner and dessert. Good thing we all exercise.

Dad and Lynn are heading over to the Duke gardens to check it out since we don't have to go to clinic today. They are also heading to the Nasher museum to see the El Greco exhibit while it is here.

I included another photo from the w-e walk through the Land Conservancy area. As Laurie put it, Tree on tree.

Autumn is Here

This being the first official day of autumn, we can all celebrate the cooler temperatures and the leaves starting to turn. We did a very nice hike yesterday with our friend Laurie in one of the Triangle Land Conservancy areas called Johnson Mill. I'd never been there but both Holly and Laurie had. It was a pretty, wooded trail near a creek for much of the trail. Laurie is in training (perpetually I think) so she carried her backpack with 35# in it. I'm lazy and only carried a bottle of water. But as my Asheville friends know, that is an improvement since I used to do hikes with little or no water. They used to tease me about drinking at home before the hike. My motto "Never Prepared" came about because I was forever hiking without all the extra "just in case" stuff like fleece jackets, raingear, more water, etc that my Asheville pals are so good at taking with them when we hike. Of course, in the mtns you really are more likely to need that stuff. I'm always surprised how much cooler it is once you get to 5000ft. And well, if we're going with Susan, it's likely to rain or snow or something weatherwise, not that it ever deters us.

We got to meet Alex's sister and mother at a brunch yesterday. So glad that I had the day off from the clinic and could join in the fun. They are visiting from Germany until later this week. This trip they visited Charleston, Savannah, and the mtns in addition to the Triangle area of course. Since their currency is worth so much more than ours, I hope they shopped alot while they were here. Maybe it'll help our economy.

I had to get platelets on Sat since they were down to 9,000. My white cell count and red blood cell count were down some too, but I didn't need whole blood. Today my counts were down a bit but again not requiring any transfusions. My next appointment is Wed when I am hoping things will be on their way up instead of down. This nadir thing is tricky. You don't know that you are at the bottom with the counts until they actually start back up.

My Dad and his wife arrived yesterday from Charleston. They are driving me to the clinic this week while my platelets are especially low. The clinic recommends that I not drive when the platelet count is super low, just in case I get in a car accident. I'm not really clear on what difference having someone else drive makes. I mean if we get in a car wreck, I'm going to bleed fast no matter whose car I'm in and regardless of whether I'm driving or not. Maybe they think being a passenger is just safer. Dunno.